b'Autologous stem Chemotherapy is given The saved autologous The stem cellscells are collected to shut down the existing stem cells are given generate a newfrom the blood stream immune systemback via an infusion immune systemwere on glatiramer acetate or an interferon studies that the procedure works best intherapy. There were a handful of natalizumab certain people. Who is an ideal HSCT candidate?patients and no ocrelizumab or alemtuzumab 1. A person with active RRMS. Ideally, thispatients. The median length of time at follow-up person has active clinical relapses and/orwas two years. What did we learn? active inammation on MRI.NonmyeloablativeautologousHSCT 2. The person does not have a progressiveappeared safe in this study. There were no form of MS. This is especially disappointingdeaths or serious side eects during the time because we have limited treatment optionsthat people were followed. Ideally, we would for progressive MS patients.like to see many years of follow-up to makesure there are no long-term eects, such as 3. The person is under the age of 50.cancers or cardiopulmonary complications due 4. For now, most HSCT candidates have hadto the chemotherapy used in the conditioning ongoing MS activity despite trying aregimen. Safety does appear to be improving standard DMT or two. Again, as we learnas we learn more about HSCT. In years past, more about HSCT, this may change.HSCTwasassociatedwithdeathratesashigh as 3 percent. Currently, there are more people interestedThe procedure appeared to be eective. in the procedure than there are placesMS progression was much less common in the performing it. This has led many in the U.S.patients treated with HSCT versus standard who have MS to seek treatment in other placesDMTs. What we really need to know now is how like Mexico or Russia. Be a smart consumer!HSCT compares in a large study to natalizumab, Do your research and speak with others whoocrelizumab, or alemtuzumab. These drugs are have gone this route. increasingly being used as rst-line treatments HSCT may oer more and more peoplein RRMS because of their eectiveness. Will with MS an eective way of stopping MS in itsHSCT be looked at as a similar first-line tracks, but we need to know more. Hopefully,option in the future? HSCT research will continue and give usHSCT researchers have learned from prior another eective tool in the ght against MS. 19 msfocusmagazine.org'